| NPI | 1164050118 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIKTORIYA R BROYAN Special Projects Manager 509-570-9322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261Q00000X |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2023-03-01 |